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What is a GreenLight Laser Prostatectomy?

GreenLight Laser Prostatectomy (or Photo-Selective Vaporisation of the Prostate – PVP) is a relatively new procedure for the treatment of urinary blockage caused by non-cancerous enlargement of the prostate (otherwise known as Benign Prostatic Hyperplasia).

Traditionally, a procedure called a Trans Urethral Resection of the Prostate (TURP) was performed to treat Benign Prostatic Hyperplasia (BPH) however GreenLight Laser Prostatectomy now offers men effective and safe treatment of BPH with fewer side effects and less time in hospital.

GreenLight Laser Prostatectomy is a minimally invasive procedure where a cystoscope (telescopic camera) and thin flexible fibre is inserted into the penis, up the urethra (water pipe), and through to the prostate. Once positioned correctly in the prostatic portion of the urethra, the surgeon looks through the cystoscope and delivers a high power of GreenLight laser energy that instantly vaporises prostatic tissue. This process continues until all of the obstructing prostate tissue is gone.

The benefits of GreenLight Laser Therapy include:

  • Immediate improvement in urinary symptoms and flow
  • Quick return to normal activities
  • No blood loss
  • Long lasting treatment
  • Less than 1% reported cases of erectile dysfunction
  • Minimal period of catheterisation (less than 24 hours in most cases)

Patients experience relief of urinary symptoms almost instantly and urine flow is typically restored soon after the procedure. GreenLight Laser Prostatectomy combines the effectiveness a TURP surgical procedure with fewer side effects.

Typically, you are required to stay in hospital overnight after this procedure, however Dr Swindle will discuss this with you and take into consideration any other medical conditions you have or if you are in a frail condition. The pictures below are before, during and after GreenLight Laser Therapy.

Before: Looking at the prostate through a cystoscope, notice the narrowing of the water pipe

During: GreenLight Laser vaporising prostatic tissue

After: GreenLight Laser having successfully vaporised the enlarged prostatic tissue, allowing the restoration of urinary flow

What is Benign Prostatic Hyperplasia (BHP)?

Benign Prostatic Hyperplasia (BPH) is a benign non-cancerous enlargement of the prostate gland and is the most common prostate problem in men aged over 50. It may also be referred to as benign prostatic hypertrophy. The prostate surrounds the urethra (the tube that urine passes through from the bladder to the penis) and as the prostate gland enlarges, it narrows the urethra making urination more difficult. This results in the following symptoms:

  • Poor flow or a weak stream
  • Urinary frequency (the need to urinate often)
  • Urinary urgency (the need to urinate in a hurry)
  • Difficulty in starting to urinate (hesitancy)
  • Waking up at night to urinate (nocturia)
  • Dribbling at the end of urination
  • Incomplete emptying of the bladder

GreenLight Laser Prostatectomy may provide you with an alternative to medicine or traditional invasive surgery for BPH. If you are interested in GreenLight Laser Prostatectomy, please discuss this with Dr Swindle.

GreenLight Laser Prostatectomy versus Trans Urethral Resection of the Prostate (TURP)

GreenLight Laser Prostatectomy and TURP treat the same condition, BPH; however there are numerous differences between the therapies. GreenLight Laser prostatectomy uses a patented GreenLight diode-pumped solid state laser. The GreenLight laser can deliver up to 180watts directly to the prostate tissue which results in rapid tissue vaporisation.

TURP excises prostate tissue via a resectoscope using electrocautery. Electrocautery cuts the prostate tissue which means that the tissue has to be physically removed.

In both procedures, catheters are inserted to help drain the urine from the bladder. After GreenLight Laser therapy, the catheter is removed on average 12.2 hours following insertion compared with 44.52 hours for a TURP. Similarly, hospital length of stay is significantly reduced in GreenLight patients. Following GreenLight Laser Prostatectomy, patients spend an average of 1.08 days in hospital compared with 3.4 days following a TURP (see graphs below).

Compared with TURP, GreenLight Laser Prostatectomy patients have:

  • Quicker improvement in urinary symptoms and flow
  • Quicker return to normal activities
  • Less intra-operative and post operative bleeding
  • Long lasting treatment
  • Less risk of sexual dysfunction.

Numerous research studies have reviewed patient outcomes following GreenLight Laser Prostatectomy, which include:

  • 88% reduction in the symptoms associated with an enlarged prostate
  • 98% improved quality of life
  • 170% improvement in urine flow, and an
  • 84% reduction in the amount of urine retained in the bladder after voiding.
About the procedure

Once you are asleep, Dr Swindle will start the operation by inserting a fine telescope down the penis into the urethra. The urethra is the tube that drains urine from the bladder to the penis. This instrument allows Dr Swindle to examine the urethra, prostate and bladder. After the prostate has been inspected, the GreenLight Laser is used to vaporise the enlarged prostate tissue.

At the end of the operation a urinary catheter, which is a soft plastic tube, is placed inside the urethra to drain the urine from the bladder. The catheter will stay in place for 6 hours or until the morning after your procedure.

The procedure usually takes about 1 hour and at the end of the procedure you will be transferred to the recovery ward, where nurses keep a close eye on you for about an hour or so before transferring you back to the ward.

If you have a spinal anaesthetic you will be awake but drowsy and it is important that you remain still whilst Dr Swindle is operating. You will not feel any pain during the operation. There will be a feeling of numbness or heaviness in your legs for several hours after the operation and this is quite normal.

GreenLight-Before-and-After

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